Giardiasis

Giardiasis
Other namesBeaver fever, giardia
Giardia cell viewed with scanning electron microscope
SpecialtyInfectious disease, gastroenterology
SymptomsDiarrhoea, abdominal pain, weight loss, nausea[1]
Usual onset1 to 3 weeks after exposure[2]
CausesGiardia duodenalis spread mainly through contaminated food or water[1]
Risk factorsHypogammaglobulinemia
Diagnostic methodStool testing[1]
Differential diagnosisIrritable bowel syndrome[1]
PreventionImproved sanitation[1]
TreatmentAntiprotozoal medications
MedicationTinidazole, metronidazole[1]
FrequencyUp to 7% (developed world), up to 30% (developing world)[1]

Giardiasis is a parasitic disease caused by the protist enteropathogen Giardia duodenalis (also known as G. lamblia and G. intestinalis), especially common in children and travelers.[3][4] Infected individuals experience steatorrhea, a type of diarrhea with fatty sticky stool; abdominal pain, weight loss, and weakness due to dehydration and malabsorption.[1] Less common symptoms include skin rash, hives and joint swelling.[1] Symptoms usually begin one to three weeks after exposure and, without treatment, may last two to six weeks or longer.[5] Some infected individuals experience mild or no symptoms and remain symptom-free even if infection persists for a long time. [6]

Giardiasis spreads via the fecal-oral route, when Giardia cysts excreted with feces contaminate food or water that is later consumed orally.[1] The disease can also spread between people and between people and animals, mainly via pets.[1][7][8] Cysts may survive for nearly three months in cold water.[1]

The microscopic identification of Giardia and its cysts in fecal samples is considered the gold standard method for the diagnosis of giardiasis.[9] Immunoassays, such as ELISA and PCR for giardia gene loci, are also available as diagnostic tools, although are not widely used due to methods complexity and costs. [9]

Prevention may be improved through proper personal hygiene practices and by cooking and sanitizing food.[1] Asymptomatic cases often do not need treatment. When symptoms are present, treatment is typically provided with either tinidazole or metronidazole.[1] Other drugs, such as nitazoxanide, albendazole, quinacrine, chloroquine, paromomycin and other drug combinations are also used in clinics. [10] Refractory giardiasis and resistant strains are reported more and more often.[11] Infection may cause a person to become lactose intolerant, so it is recommended to temporarily avoid lactose following an infection or use lactase supplements.[1]

Giardiasis occurs worldwide.[12] It is one of the most common parasitic human diseases.[3] Infection rates are as high as 7% in the developed world and 30% in the developing world.[1] In 2013, there were approximately 280 million people worldwide with symptomatic cases of giardiasis.[3] The World Health Organization classifies giardiasis as a neglected disease.[1] It is popularly known as beaver fever[13] in North America.

  1. ^ a b c d e f g h i j k l m n o p q Minetti C, Chalmers RM, Beeching NJ, Probert C, Lamden K (October 2016). "Giardiasis" (PDF). BMJ. 355: i5369. doi:10.1136/bmj.i5369. PMID 27789441. S2CID 220092781.
  2. ^ "Giardia. General information". CDC. 21 July 2015. Archived from the original on 17 November 2016. Retrieved 17 November 2016.
  3. ^ a b c Esch KJ, Petersen CA (January 2013). "Transmission and epidemiology of zoonotic protozoal diseases of companion animals". Clinical Microbiology Reviews. 26 (1): 58–85. doi:10.1128/CMR.00067-12. PMC 3553666. PMID 23297259.
  4. ^ Buret, A.G. (September 2008). "Pathophysiology of enteric infections with Giardia duodenalis". Parasite. 15 (3): 261–265. doi:10.1051/parasite/2008153261. ISSN 1252-607X. PMID 18814692.
  5. ^ Cite error: The named reference CDCSymptoms was invoked but never defined (see the help page).
  6. ^ "Giardiasis fact sheet". www.health.nsw.gov.au. Retrieved 2025-06-03.
  7. ^ Cite error: The named reference Heyworth2016 was invoked but never defined (see the help page).
  8. ^ Cacciò, Simone M.; Lalle, Marco; Svärd, Staffan G. (December 2018). "Host specificity in the Giardia duodenalis species complex". Infection, Genetics and Evolution. 66: 335–345. Bibcode:2018InfGE..66..335C. doi:10.1016/j.meegid.2017.12.001. PMID 29225147.
  9. ^ a b Vicente, Bruno; Freitas, Anna De; Freitas, Marcus; Midlej, Victor (2024-02-07). "Systematic Review of Diagnostic Approaches for Human Giardiasis: Unveiling Optimal Strategies". Diagnostics. 14 (4): 364. doi:10.3390/diagnostics14040364. ISSN 2075-4418. PMC 10887752. PMID 38396402.
  10. ^ Lalle, Marco; Hanevik, Kurt (2018-10-24). "Treatment-refractory giardiasis: challenges and solutions". Infection and Drug Resistance. 11: 1921–1933. doi:10.2147/IDR.S141468. PMC 6207226. PMID 30498364.
  11. ^ Nabarro, L. E. B.; Lever, R. A.; Armstrong, M.; Chiodini, P. L. (2015-08-01). "Increased incidence of nitroimidazole-refractory giardiasis at the Hospital for Tropical Diseases, London: 2008–2013". Clinical Microbiology and Infection. 21 (8): 791–796. doi:10.1016/j.cmi.2015.04.019. ISSN 1198-743X. PMID 25975511.
  12. ^ Cite error: The named reference CDC_Giardiasis was invoked but never defined (see the help page).
  13. ^ "Giardiasis (beaver fever)". New York State Department of Health. January 2022. Archived from the original on 20 January 2022. Retrieved 27 March 2022.
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